血清组织蛋白酶S、颗粒蛋白前体、趋化因子配体12与慢性阻塞性肺疾病急性加重风险的关系

石宝玉.血清组织蛋白酶S、颗粒蛋白前体、趋化因子配体12与慢性阻塞性肺疾病急性加重风险的关系[J].内科急危重症杂志,2023,29(5):377-380

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DOI：10.11768/nkjwzzzz20230505

中文关键词: 慢性阻塞性肺疾病稳定期急性加重组织蛋白酶S 颗粒蛋白前体趋化因子配体12

英文关键词:

基金项目:苏州市科技计划项目(No：SKJY2021124)

作者	单位	E-mail
石宝玉	苏州市立医院	ffij882@163.com

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中文摘要:

摘要目的: 探讨血清组织蛋白酶S（CTSS）、颗粒蛋白前体（PGRN）、趋化因子配体12（CXCL12）与稳定期慢性阻塞性肺疾病（SCOPD）急性加重风险的关系及其联合预测效能。方法：选取202例SCOPD患者，根据是否发生急性加重分为SCOPD组（138例）与COPD急性加重期（AECOPD）组（64例），比较2组患者血清CTSS、PGRN、CXCL12水平，不同第一秒呼气容积占预计值百分比（FEV1％）及稳定期COPD评估测试（CAT）评分患者血清CTSS、PGRN、CXCL12水平，评价各血清指标对SCOPD患者急性加重风险的预测效能。结果：AECOPD组患者血清CTSS、PGRN、CXCL12水平高于SCOPD组（P均＜0.05）；Pearson相关性分析显示，血清CTSS、PGRN、CXCL12与FEV1％呈负相关（r=-0.830、-0.811、-0.729，P均＜0.001），与CAT评分呈正相关（r=0.661、0.767、0.777，P均＜0.001）；血清CTSS、PGRN、CXCL12高水平SCOPD患者发生急性加重的风险分别是低水平患者的2.089倍、2.294倍、2.359倍；血清CTSS、PGRN、CXCL12联合预测SCOPD患者急性加重风险的AUC为0.923（95%CI：0.877～0.956），优于各指标单独预测。结论：血清CTSS、PGRN、CXCL12水平异常升高可显著增加SCOPD急性加重的风险，三者联合检测有一定的预测效能。

英文摘要:

Abstract Objective: To investigate the relationship between serum cathepsin S (CTSS), progranulin (PGRN), chemokine ligand 12 (CXCL12) and the risk of acute exacerbation of stable chronic obstructive pulmonary disease (SCOPD) and their combined prediction efficacy. Methods: Totally, 202 patients with SCOPD were selected and divided into SCOPD group (n=138) and acute exacerbation of COPD (AECOPD) group (n=64) according to whether acute exacerbation occurred. The serum CTSS, PGRN, and CXCL12 levels were compared between the two groups, and the predictive efficacy of each serum index on the risk of acute exacerbation in SCOPD patients was evaluated. Results: Serum CTSS, PGRN, and CXCL12 levels were significantly higher in the AECOPD group than in the SCOPD group (P< 0.05).Serum CTSS, PGRN and CXCL12 were negatively correlated with FEV1% (r=-0.830, -0.811, -0.729, P<0.001) and positively correlated with CAT score (r=0.661, 0.767, 0.777, all P< 0.001).The risk of AECOPD was 2.089, 2.294, and 2.359 times higher in patients with high levels of serum CTSS, PGRN, and CXCL12 than in patients with low levels of SCOPD, respectively.The AUC for the combination of serum CTSS, PGRN, and CXCL12 to predict the risk of acute exacerbation in SCOPD patients was 0.923 ( 95% CI: 0.877 to 0.956), which was greater than the prediction of each index alone.Conclusions: Abnormal increase of serum CTSS, PGRN and CXCL12 can significantly increase the risk of acute exacerbation of SCOPD, and the combination of three indicators has certain predictive efficacy and can be used as a reference for early clinical prediction.